How Would You Deal with this Referral?

[sam816]

A doctor's office is ending their contract with MAPD plan A, they referred some of their patients who are on plan A to me, wanting me to help them sign up for plan B. The problem is plan B is a captive one and I don't have it. I told those who called I could show them plan C which allows them to see the same doctor but is not as good as plan A, but I don't represent plan B so I can't help them with that.

The problem is plan B is more competitive than plan C, would you go as far as telling them that they will be better off by just calling plan B themselves?

 

[sman]

A doctor's office is ending their contract with MAPD plan A, they referred some of their patients who are on plan A to me, wanting me to help them sign up for plan B. The problem is plan B is a captive one and I don't have it. I told those who called I could show them plan C which allows them to see the same doctor but is not as good as plan A, but I don't represent plan B so I can't help them with that.

The problem is plan B is more competitive than plan C, would you go as far as telling them that they will be better off by just calling plan B themselves?

Since we're outside of AEP, my recommendation would be to tell them to find a new doctor since they won't be able to change plans until next year (unless they can get a SEP from Medicare or they are DUAL/SNP).

 

[sam816]

Since we're outside of AEP, my recommendation would be to tell them to find a new doctor since they won't be able to change plans until next year (unless they can get a SEP from Medicare or they are DUAL/SNP).

Sorry, I should have said all these plans are DUAL/SNP therefore they can switch plans outside the AEP.

 

[vic120]

Sorry, I should have said all these plans are DUAL/SNP therefore they can switch plans outside the AEP.

I have a doc that refers to me on occasion for MA. I was very straightforward on what plans I do and do not represent, especially because this year, one of the plans the doc likes is one I do not represent.

I also put together a grid including benefits of plans I represent.I also provided direct number to the plans I do not represent

The Doc appreciates this and refers whenever feasible and sends direct when needed.

The way I look at it is it is free deals anyway, whatever I get I am am grateful, I don't stress what I don't because of limitations.It all works out well enough for me

 

[Todd King]

A doctor's office is ending their contract with MAPD plan A, they referred some of their patients who are on plan A to me, wanting me to help them sign up for plan B. The problem is plan B is a captive one and I don't have it. I told those who called I could show them plan C which allows them to see the same doctor but is not as good as plan A, but I don't represent plan B so I can't help them with that.

The problem is plan B is more competitive than plan C, would you go as far as telling them that they will be better off by just calling plan B themselves?

Would it be that difficult for you to pick up plan B and have it available?

 

[sam816]

Would it be that difficult for you to pick up plan B and have it available?

As far as I know it is a captive plan and they don't sell it through independent agents.

 

[vic120]

As far as I know it is a captive plan and they don't sell it through independent agents.

what is the name of company?

 

[sman]

Sorry, I should have said all these plans are DUAL/SNP therefore they can switch plans outside the AEP.

I'm a firm believer in doing what is best for the client. If we're talking a big difference in benefits, you've got to tell them the other plan could be a better option for them. I couldn't in good conscience knowingly enroll them in an inferior plan.

Just my two cents.

 

[Chazm]

If it's a dual eligible plan, isnt it all $0 copays anyways?
If so I would put them with plan C. Only thing extra is over the counter etc

 

[wehotex]

As far as I know it is a captive plan and they don't sell it through independent agents.

Any chance of befriending one of those captive agents? I know from experience in not being able to write a preferred plan that it sucks to have to give away what you have worked for in the hope that the lead recipient might reciprocate. I kissed a lot of frog agents until I found the princes/princesses that actually cared enough to give back. It's always best to give the client the best option. If you don't, they could only end up disenrolling eventually.